Annals of Oncology Advance Access first published online on February 9, 2006
This version published online on March 8, 2006
Annals of Oncology, doi:10.1093/annonc/mdl009
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1 Centre Pluridisciplinaire d'Oncologie, University of Lausanne Hospitals (CHUV), Lausanne, Switzerland
* To whom correspondence should be addressed. Background: Exclusive liver metastases occur in up to 40% of patients with uveal melanoma associated with a median survival of 2-7 months. Single agent response rates with commonly available chemotherapy are below 10%. We have investigated the use of fotemustine via direct intra-arterial hepatic (i.a.h.) administration in patients with uveal melanoma metastases. Patients and methods: A total of 101 patients from seven centers were treated with i.a.h. fotemustine, administered intra-arterially weekly for a 4-week induction period, and then as a maintenance treatment every 3 weeks until disease progression, unacceptable toxicity or patient refusal. Results: A median of eight fotemustine infusions per patient were delivered (range 1-26). Catheter related complications occurred in 23% of patients; however, this required treatment discontinuation in only 10% of the patients. The overall response rate was 36% with a median overall survival of 15 months and a 2-year survival rate of 29%. LDH, time between diagnosis and treatment start and gender were significant predictors of survival. Conclusions: Locoregional treatment with fotemustine is well tolerated and seems to improve outcome of this poor prognosis patient population. Median survival rates are among the longest reported and one-third of the patients are still alive at 2 years. This version contains the correct acceptance date in 2006.
Received October 30, 2005
Revised December 30, 2005
Accepted January 9, 2006
original article
Intra-arterial hepatic fotemustine for the treatment of liver metastases from uveal melanoma: experience in 101 patients
S. Peters 1 
,
V. Voelter 1 ,
L. Zografos 2,
S. Pampallona 3,
R. Popescu 4,
M. Gillet 5,
W. Bosshard 1,
G. Fiorentini 6,
M. Lotem 7,
R. Weitzen 8,
U. Keilholz 9,
Y. Humblet 10,
S. Piperno-Neumann 11,
R. Stupp 1,
and
S. Leyvraz 1 *
2 Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland
3 ForMed, Evolène, Switzerland
4 Centre Pluridisciplinaire d'Oncologie, University of Lausanne Hospitals (CHUV), Lausanne, Switzerland; Current affiliation: Oncology Center, Hirslanden Clinic, Aarav, Switzerland
5 Département de Chirurgie, University of Lausanne Hospitals (CHUV), Lausanne, Switzerland
6 Ospedale Generale San Giuseppe, Empoli, Italy
7 Sharett Institute of Oncology, Hadassah Hebrew University Hospital, Jerusalem, Israel
8 Sheba Medical Center, Tel Hashomer, Israel
9 Medizinische Klinik II, Benjamin Franklin Hospital of the Free University, Berlin, Germany
10 Centre du Cancer, St Luc University Hospital, Brussels, Belgium
11 Institut Curie, Paris, France
S. Leyvraz, E-mail: Serge.Leyvraz{at}hospvd.ch
Abstract
These authors contributed equally to this work.
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